Amenorrhoea (Secondary)
Pathway Home
Population Covered By The Guidance
This pathway provides guidance on investigating adult female patients with unexplained secondary amenorrhoea.
Date reviewed: February 2013
Date of next review: June 2023
Published: April 2013
Quick User Guide
Move the mouse cursor over the PINK text boxes inside the flow chart to bring up a pop up box with salient points.
Clicking on the PINK text box will bring up the full text.
The relative radiation level (RRL) of each imaging investigation is displayed in the pop up box.
| SYMBOL | RRL | EFFECTIVE DOSE RANGE |
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None | 0 |
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Minimal | < 1 millisieverts |
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Low | 1-5 mSv |
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Medium | 5-10 mSv |
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High | >10 mSv |
Images
Image GalleryNote: These images open in a new page |
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| 1a |  |
Pituitary Microadenoma Image 1a (T1 weighted), 1b and 1c (T2 weighted) (Magnetic Resonance Imaging): There is a lesion seen within the pituitary gland centred to the right of the midline which is of high signal intensity on the T2 weighted imaging and shows slightly reduced signal intensity compared with adjacent pituitary on the T1 weighted imaging. Overall, the lesion measures up to 6mm. The lateral aspect of the lesion is abutting the medial aspect of the cavernous segment of the right internal carotid artery. The superior aspect of the pituitary is directly adjacent to the inferior aspect of the optic chiasm. The appearances are consistent with a pituitary microadenoma. |
| 1b |  |
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| 1c |  |
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| 2a |  |
Pituitary Macroadenoma Image 2a and 2b: Post-mortem specimens showing a circumcribed nodular tumour arising from the anterior pituitary consistent with a macroadenoma. |
| 2b |  |
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| 2c |  |
Image 2c (H&E, x2.5) and 2d (H&E, x20): Histological sections demonstrating a circumscribed lesion composed of sheets of uniform polygonal cells with centrally placed nuclei and amphophilic cytoplasm. The features are consistent with a pituitary adenoma. |
| 2d |  |
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Teaching Points
Teaching Points
- Diagnostic Imaging may reveal a cause of secondary amenorrhoea in the following cases
- Central hypogonandism where a functioning or non-functioning pituitary adenoma is present
- Ultrasonography of the ovaries in suspected polycystic ovarian syndrome or primary ovarian failure
Information for Consumers
Information for Consumers
Information from this website |
Information from the Royal Australian and New Zealand College of Radiologists’ website |
Consent to Procedure or Treatment Radiation Risks of X-rays and Scans |
Radiation Risk of Medical Imaging During Pregnancy Radiation Risk of Medical Imaging for Adults and Children |
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